2313. Patient Preferences Regarding Contrast-Enhanced Imaging in the Screening Population
Authors * Denotes Presenting Author
  1. Daniel Son *; Beth Israel Deaconess Medical Center
  2. Jordana Phillips; Beth Israel Deaconess Medical Center
  3. Tejas Mehta; Beth Israel Deaconess Medical Center
  4. Valerie Fein-Zachary; Beth Israel Deaconess Medical Center
  5. Rashmi Mehta; Beth Israel Deaconess Medical Center
  6. Alexander Brook; Beth Israel Deaconess Medical Center
  7. Vandana Dialani; Beth Israel Deaconess Medical Center
Breast MRI and Contrast-enhanced mammography (CEM) are associated with improved cancer detection compared with conventional mammography (MG). There is increasing interest in offering these modalities for screening, however patient preferences towards these exams is unknown. Our purpose is to understand patient preferences towards CEM and MRI for cancer screening.

Materials and Methods:
An anonymous survey was offered to all patients having screening MG at a single academic institution from December 27th 2019 to March 6th 2020. The survey first provided information on MRI and CEM. Survey questions related to: (1) patients’ background experiences (2) patients’ concern for aspects of MRI and CEM measured using a 5-point Likert scale, and (3) financial considerations. Mann-Whitney and chi-squared tests were used for analysis.

75% (1011/1349) patients completed the survey. 53% (523/987) reported dense breasts and of those, 48% (250/525) had additional screening. 50% (494/981) had experienced a callback, 29% (283/976) had a benign biopsy, and 14% (125/923) had prior CEM/MRI. 35% (332/956) were satisfied with MG alone for screening. A majority of patients were neutral or not concerned with radiation exposure, IV contrast allergy, IV line placement, claustrophobia, and false positive exams. 55% (470/860) were willing to pay at least $250-500 for a screening MRI. Those reporting dense breasts were significantly less satisfied with MG for screening (p<0.001) and willing to pay a higher cost for MRI (p<0.001). If patients had prior CEM/MRI, there was less concern for an allergic reaction (p<0.001), IV placement (p=0.025), and claustrophobia (p=0.006). There was less concern for false positives if they had a prior benign biopsy (p=0.029) or prior CEM/MRI (p=0.005) and less concern for IV placement if they had dense breasts (p=0.007) or a previous callback (p=0.013).

The screening population may accept CEM or MRI as a screening exam despite its risks and cost, especially patients with dense breasts and patients who have had prior CEM/MRI.